Dabigatran (Pradaxa®)
Biochemistry
| Molecular mass | 627,73 Da |
| Bioavailability | 6,5 % |
| Peak concentration | 2-3 hours after drug administration |
| Half-life | 13 to 18 hours |
Dabigatran is a direct, reversible thrombin inhibitor. The drug comes in form of dabigatran etexilate, which is pharmacologically inactive. After oral administration, dabigatran etexilate is rapidly absorbed and converted to dabigatran by esterase-catalyzed hydrolysis in plasma and liver.
Clinical significance
The following applications are indicated: primary prevention of venous thromboembolic events in adults after elective hip or knee replacement surgery, prevention of stroke and systemic embolism in adults with non-valvular atrial fibrillation with one or more risk factors, treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) as well as prevention of recurrent DVT and PE.
Indication
- Routine monitoring is not necessary
- The measurement of coagulation inhibition in combination with dabigatran may be useful to avoid excessive exposure to dabigatran in the presence of additional risk factors
Literature
- Harenberg J, Giese C, Marx S, Krämer R. Determination of dabigatran in human plasma samples. Semin Thromb Hemost. 38(1):16-22, 2013.
- Cini M, Legnani C, Cosmi B, Testa S, Dellanoce C, Paoletti O, Marcucci R, Poli D, Paniccia R, Pengo V, Tripodi A, Palareti G. START-Laboratory RegisterComparison of five specific assays for determination of dabigatran plasma concentrations in patients enrolled in the START-Laboratory Register. Int J Lab Hematol. 40(2):229-236, 2018.